Pain and Psychosocial Adjustment

Because pain is a central feature of SCD, a key concern of patients, families, and medical professionals is pain management and coping. The reader is referred to Chapter 9 for a general review of pediatric pain and descriptions of intervention techniques. (For reviews related to pain management in SCD, see Chen et al. 2004; Swain et al. 2006.) In addition to the expected emotional and psychological distress associated with chronic pain, increased levels of pain and related hospitalizations in children with SCD have also been associated with increased rates of psychosocial difficulties, including high rates of school absenteeism and removal from the peer group. As discussed earlier, children with SCD are also at increased risk for psychological and emotional adjustment problems, including depression, anxiety, and social difficulties (Barbarin et al. 1994; Brown et al. 1993b; Thompson et al. 1995). Therefore, interventions that aim to decrease pain and to increase effective coping are important in promoting children's physical, psychological, and social well-being.

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